Management of Pace-Terminated Ventricular Arrhythmias

Pokorney, Sean D.; Al‐Khatib, Sana M.

doi:10.1016/j.ccep.2015.05.009

Cited by 3 publications

(4 citation statements)

References 87 publications

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“…These cellular mechanisms importantly contribute for developing arrhythmias, and death in AMI patients. Despite continuous advances in AMI treatment, a high ratio of patients dies suddenly in the early hours before arriving at the hospital [6][7][8][9]. Most of these early deaths are due to complex ventricular arrhythmias (VA) and atrio-ventricular blockade (AVB) [6][7][8][9].…”

Section: Editorialmentioning

confidence: 99%

“…Due to involvement of intracellular Ca 2+ overload in cardiac arrhythmias caused by myocardial I/R, the use of pharmaceuticals that reduce this Ca2+ overload represents an alternative pharmacological approach to the treatment of ischemic cardiac diseases in humans, including AMI. Nonetheless, the cardiac reperfusion (R) continues to be the therapy more used to treat ICD [6][7][8][9]. Among the various risk factors for persuing cardiac I/R, we can highlight obesity; this disease has worldwide importance, and it is intrinsically related to cardiovascular diseases (e.g.…”

Section: Editorialmentioning

confidence: 99%

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Potential Cardioprotective Effects of Orlistat for Treatment of Myocardial Infarction

Rodrigues¹,

Tavares²,

Araújo³

et al. 2017

J Thrombo Cir

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Section: Editorialmentioning

confidence: 99%

Section: Editorialmentioning

confidence: 99%

Potential Cardioprotective Effects of Orlistat for Treatment of Myocardial Infarction

Rodrigues¹,

Tavares²,

Araújo³

et al. 2017

J Thrombo Cir

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“…Scar-related myocardial reentry is the main mechanism of sustained monomorphic VT in patients with structural heart disease (4) and reentrant tachycardia is susceptible to pace termination, which makes ATP therapy effective (5). In addition to being a painless therapy, it is simple to programme and reduces battery drain (6).…”

Section: Introductionmentioning

confidence: 99%

Arrhythmogenicity of anti-tachycardia pacing programming parameters in patients with structural heart disease and implantable defibrillators

2023

JPTCP

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Background: Anti-tachycardia pacing therapy (ATP) is an effective, painless therapy for ventricular tachycardia (VT) termination. However, some patients experience VT acceleration that might degenerate into ventricular fibrillation (VF), leading to shock therapy. The aim of the study was to investigate the incidence of VT acceleration in patients with structural heart disease and implantable defibrillators and its relation to the ATP programming parameters. Methods: A total of 448 monomorphic VT episodes in 60 patients with structural heart disease and an ICD implant were reviewed after being retrieved from the programmers. The patients' clinical data and the episodes' details were analysed. Results: ATP therapy was successful in terminating the VT in 70% of the analysed episodes. The incidence of VT acceleration in our studied patients was 8.5%. Patients with accelerated VT had a lower ejection fraction compared to patients with ATP-successful episodes. In the accelerated episodes, ramp pacing and scanning were frequently turned on. When VT-accelerated episodes were compared to ATP-successful ones, the number of ATP bursts was higher and the adaptive cycle length was shorter. Conclusions: Ventricular tachycardia acceleration by ATP therapy is likely to occur in patients with a severely impaired ejection fraction. Scanning, ramp pacing, and the number of ATP bursts delivered had a significant effect on VT acceleration. Scanning and ramp pacing are better to be turned off, and a lesser number of ATP bursts with a longer adaptive CL should be delivered.

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“…Most of these early deaths are due complex ventricular arrhythmias (VA) and atrio-ventricular blockade (AVB) [11,12]. Surprisingly, there is still lack of knowledge about the exact time of these early malignant arrhythmias and their cellular, and molecular, mechanisms.…”

Section: Introductionmentioning

confidence: 99%

A Simple and Efficient Methodology for the Study of Cardioprotective Drugs in Animal Model of Cardiac Ischemia-Reperfusion

Tavares¹,

Francisco²,

Menezes-Rodrigues³

et al. 2017

J Mol Imaging Dynam

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To study cardioprotective drugs, we developed a simple and efficient methodology to evaluate effects of drugs on cardiac electrical activity using electrocardiogram (ECG) in rats submitted to cardiac ischemia-reperfusion (I/R). Using adult male Wistar rats (14 -16-week-old) anesthetized (urethane 1.25 g/kg, i.p.) and kept under mechanical ventilation, we used surgical procedures to induce cardiac I/R by means mechanical occlusion of left anterior descendent coronary artery for 10 min (ischemia) with silk suture (tourniquet) followed by its removal to allow coronary recirculation (reperfusion). To evaluate the effects of surgical process, a group of rats (SHAM-operated) was submitted to surgical procedures previously described, but without coronary occlusion. To evaluate cardiac electrical activity in rats submitted to cardiac I/R and SHAM-operated, the ECG system was coupled to animal body to determine the incidence of ventricular arrhythmia (VA), atrio-ventricular blockade (AVB) and lethality (LET). To evaluate injury biomarkers production in rats submitted to cardiac I/R and SHAM-operated, serum concentrations of creatine kinase fraction (MB/CK-MB) and troponin I were determined by biochemical techniques. Using the methodology proposed in this work, we observed that VA, AVB and LET incidence was significantly higher in cardiac I/R group (85%, 79% and 70%, respectively) than in SHAM-operated group (0%, 0% and 0%, respectively). Serum levels of CK-MB and troponin I were also significantly higher in cardiac I/R (1,850 ± 222 U/L and 0.031 ± 0.009 ng/mL, respectively) compared to SHAM-operated group (808 ± 72 U/L and 0.200 ± 0.027 ng/mL). To evaluate efficiency of methodology proposed in this work to study the effect of cardioprotective drugs, the effects of the L-type Ca 2+ channel blocker (CCB) nifedipine (30 mg/kg, intravenously -IV) in rats submitted to cardiac I/R were studied. The treatment with nifedipine (before ischemia) significantly reduced the incidence of VA (from 85% to 28%), AVB (from 79% to 14%), and LET (from 70% to 14%). These results indicate that the methodology described in the present work is simple, and efficient, to evaluate cardiac functional and biochemical alterations induced by cardiac I/R, and also the study of cardioprotective drugs in rats. This methodology could contribute to the development of new pharmacological cardioprotective strategies for to treatment of ischemic cardiac diseases in humans, such as myocardial infarction.

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Management of Pace-Terminated Ventricular Arrhythmias

Cited by 3 publications

References 87 publications

Potential Cardioprotective Effects of Orlistat for Treatment of Myocardial Infarction

Potential Cardioprotective Effects of Orlistat for Treatment of Myocardial Infarction

Arrhythmogenicity of anti-tachycardia pacing programming parameters in patients with structural heart disease and implantable defibrillators

A Simple and Efficient Methodology for the Study of Cardioprotective Drugs in Animal Model of Cardiac Ischemia-Reperfusion

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